1. No solvency – housing crackdown and displaced persons make distribution impossible.
Plus News – Your Author, 5/10/06 http://www.plusnews.org/report.aspx?reportid=39584
Zimbabwe, which has one of the world's highest rates of HIV infection, is going through a severe economic crisis. There are shortages of food and fuel and inflation reached 913.6 percent in March.
The government's response to the AIDS crisis was to declare a state of emergency in 2002, allowing cheaper generic drugs to be imported as well as locally made under World Trade Organisation rules. But local generic drug manufacturers are hamstrung by the scarcity of foreign currency, which they need to import raw materials to make the ARVs.
Last year's Operation Murambatsvina ('Clean Out Garbage'), officially aimed at rooting out the blackmarket and criminals, encompassed unapproved housing owned or rented by the poor, and made life even more difficult. A year after the campaign, AIDS NGOs are still trying to locate displaced HIV-positive people, and fear that many have had to discontinue their drug treatment.
"We still haven't traced some clients ... they've vanished as far as we're concerned. Others disappeared for weeks and were homeless and incomeless, which means they were not eating, and that's a problem when taking [ARVs]," Lynde Francis, who runs The Centre, an HIV/AIDS NGO with 4,500 registered clients, told IRIN.
2. UK increases in aid will solve the epidemic now.
UK Department for International Development. 7/18/07.
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/LRON-759G8N?OpenDocument>. [Bhattacharjee]
Giving her maiden speech in the House of Lords, the day before a House of Commons debate on Zimbabwe, International Development Minister Shriti Vadera today announced a UK commitment of £50 million over five years to help more than 2 million of Zimbabwe's poorest people in the midst of a humanitarian crisis. Shriti Vadera said: "The people of Zimbabwe face a humanitarian crisis. A quarter of the population have fled to neighbouring countries, and half those remaining urgently need food aid. Each week over 3,000 people die of HIV/AIDS. "To help those immediately at risk I would like to announce that DFID is today committing £50 million to extend the Protracted Relief Programme for the next five years. The programme will be delivered entirely through NGOs to provide seeds, fertilisers, livestock and access to HIV/AIDS care to assist 2 million of the most vulnerable Zimbabweans." As with all DFID programmes in Zimbabwe, no funding goes directly to the government. The programme is closely monitored to ensure that there is no political interference before the support reaches the intended beneficiaries, who include former farm workers and families forced to leave their homes. The Protracted Relief Programme (PRP) builds on an existing successful programme and will enable poor families to begin to provide for themselves. The £50 million announced today brings the total UK humanitarian commitment to Zimbabwe since 2001 to over £200 million.
3. No solvency – people can’t get tested and stigmatisation prevents using the drugs.
Action Contre la Faim – Your Author, 1-2006 (“Zimbabwe: insight into the humanitarian crisis and food politics,” PDF from - http://www.kubatana.net/html/archive/foodse/060504acf.asp?sector=FOODSE p.18 [T Chenoweth])
Most of the interviewed people in both districts did not know their HIV/AIDS status for two main reasons: - The VCT (Voluntary Counselling and Testing) or PPTCT (Prevention of Parents To Child Transmission) tests are only available at hospital level (1 hospital in the whole Zvishavane district and 3 in Chipinge).n- Most people say they would rather ignore their status as HIV/AIDS might be a source of stigmatisation.
3. No solvency - Lack of infrastructure, doctors, and HIV testing means the drugs can’t be distributed anyways.
Washington Post – Your Author, 4/20/05 (In Rural Zimbabwe AIDS Still Means Death, http://www.washingtonpost.com/wp-dyn/articles/A2441-2005Apr19.html)
By this measure, Mataruse could not live in a worse place. Zhulube is a remote region in southern Zimbabwe, a country whose public health system has been decimated by economic collapse and international isolation. In southern Africa, the epicenter of the global pandemic, no country is as far behind in treating AIDS, according to World Health Organization statistics. An estimated 1.8 million Zimbabweans have HIV, the virus that causes AIDS. Of that group, 295,000 need antiretroviral treatment immediately, but only 8,000 -- less than 3 percent -- are getting it, according to a December report from WHO. The need for treatment is growing far more quickly than the capacity to provide it, the report shows. Mataruse's local clinic, an arduous three-mile walk from her home, lacks not only antiretroviral medicine but also the kits needed to test for HIV. Even the basics of modern health care -- syringes, intravenous fluid, antibiotics and elastic bandages -- are frequently out of stock, a nurse at the clinic said. There are no doctors there. The nurses who have chronicled Mataruse's decline have never mentioned either HIV or AIDS, she said, and neither term appears in the battered paper folder of medical records she keeps. The surge of international funding that is beginning to prolong the lives of Africans with AIDS has bypassed Zimbabwe almost entirely. The United Nations, the World Bank and President Bush's AIDS initiative are focusing on other countries, in large part because President Robert G. Mugabe's reputation as one of the most undemocratic and anti-Western African leaders has kept donors away from Zimbabwe. "There is tension between the international community and the government of Zimbabwe," said James Elder, a UNICEF spokesman in Harare, the capital. But he added, "Don't take it out on children. Let's move the attention a little bit away from politics and put it on people." The average amount of international funding each year in southern Africa is $74 per person infected with HIV, according to UNICEF. In Zimbabwe, that figure is $4. The discrepancy is even more dramatic when compared with sums received over the border in Zambia, where international donors provide $187 per infected person. And though Zimbabwe is slated to get a grant of $14 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the same agency rejected a request in December for more than $250 million, citing technical flaws in the proposal. The results can be seen in the relative availability of medicine. In Zambia, antiretroviral drugs are reaching 13 percent of those who need them, according to WHO statistics. Zimbabwe's southwestern neighbor, Botswana, which has a much higher per capita income and receives substantial health care funding from the Bill and Melinda Gates Foundation, is getting antiretrovirals to 50 percent of those who need it. Even in South Africa, which has been widely criticized for its sluggish response to AIDS, antiretrovirals are reaching 7 percent of those who need the drugs. In major South African cities such as Johannesburg and Cape Town, the waiting list for government-subsidized AIDS medicines has virtually disappeared, doctors there said. While the governments of most countries hit hardest by AIDS have cooperated with international donors, Mugabe's government has grown increasingly belligerent toward the West, especially the United States and Britain, which he regularly attacks with caustic rhetoric. Mugabe has won some international praise for his willingness to discuss AIDS publicly, in contrast to South African President Thabo Mbeki. He revealed in a speech last year that members of his family had contracted the disease, and the government also instituted a tax supposedly intended to generate resources to fight AIDS. But many Zimbabweans express doubt that the money raised by the levy has gone to treating or preventing AIDS. There are few public health messages about HIV anywhere in the country, aside from a handful of vaguely worded billboards promoting condom use. The reputation of Mugabe and his ruling party for siphoning public funds for private gain, meanwhile, has made the major international donors even more reluctant to deal with him. And the parliament passed a law last year to bring independent aid groups, which might provide an alternative for delivering international health assistance, under government control. The victims in this standoff between Mugabe and Western donors are Zimbabweans with AIDS, activists here said. "You can't win this battle by fighting the government, because they control the resources," said Lynde Francis, an AIDS activist in nearby Bulawayo. "It doesn't matter how much you whine and moan about the government. It doesn't get you anywhere to withdraw help." One of the few international donors to make a significant commitment to fighting AIDS in Zimbabwe is the studiously non-partisan French medical group Doctors Without Borders, which has managed to make Bulawayo the only city in Zimbabwe where antiretrovirals are widely available. A Zimbabwean company is also beginning to make a generic version of a popular combination of antiretroviral drugs, which might improve access. But here in Zhulube, a dusty, destitute village in a gold-mining region, the public health system has trouble handling even comparatively simple maladies such as pneumonia or infected wounds. Mataruse has walked to the clinic almost monthly in the past two years, complaining of coughs, headaches, fever, diarrhea and night sweats. Her health records show she was routinely given nothing more than painkillers.
Plus News – Your Author, 5/10/06 http://www.plusnews.org/report.aspx?reportid=39584
Zimbabwe, which has one of the world's highest rates of HIV infection, is going through a severe economic crisis. There are shortages of food and fuel and inflation reached 913.6 percent in March.
The government's response to the AIDS crisis was to declare a state of emergency in 2002, allowing cheaper generic drugs to be imported as well as locally made under World Trade Organisation rules. But local generic drug manufacturers are hamstrung by the scarcity of foreign currency, which they need to import raw materials to make the ARVs.
Last year's Operation Murambatsvina ('Clean Out Garbage'), officially aimed at rooting out the blackmarket and criminals, encompassed unapproved housing owned or rented by the poor, and made life even more difficult. A year after the campaign, AIDS NGOs are still trying to locate displaced HIV-positive people, and fear that many have had to discontinue their drug treatment.
"We still haven't traced some clients ... they've vanished as far as we're concerned. Others disappeared for weeks and were homeless and incomeless, which means they were not eating, and that's a problem when taking [ARVs]," Lynde Francis, who runs The Centre, an HIV/AIDS NGO with 4,500 registered clients, told IRIN.
2. UK increases in aid will solve the epidemic now.
UK Department for International Development. 7/18/07.
<http://www.reliefweb.int/rw/RWB.NSF/db900SID/LRON-759G8N?OpenDocument>. [Bhattacharjee]
Giving her maiden speech in the House of Lords, the day before a House of Commons debate on Zimbabwe, International Development Minister Shriti Vadera today announced a UK commitment of £50 million over five years to help more than 2 million of Zimbabwe's poorest people in the midst of a humanitarian crisis. Shriti Vadera said: "The people of Zimbabwe face a humanitarian crisis. A quarter of the population have fled to neighbouring countries, and half those remaining urgently need food aid. Each week over 3,000 people die of HIV/AIDS. "To help those immediately at risk I would like to announce that DFID is today committing £50 million to extend the Protracted Relief Programme for the next five years. The programme will be delivered entirely through NGOs to provide seeds, fertilisers, livestock and access to HIV/AIDS care to assist 2 million of the most vulnerable Zimbabweans." As with all DFID programmes in Zimbabwe, no funding goes directly to the government. The programme is closely monitored to ensure that there is no political interference before the support reaches the intended beneficiaries, who include former farm workers and families forced to leave their homes. The Protracted Relief Programme (PRP) builds on an existing successful programme and will enable poor families to begin to provide for themselves. The £50 million announced today brings the total UK humanitarian commitment to Zimbabwe since 2001 to over £200 million.
3. No solvency – people can’t get tested and stigmatisation prevents using the drugs.
Action Contre la Faim – Your Author, 1-2006 (“Zimbabwe: insight into the humanitarian crisis and food politics,” PDF from - http://www.kubatana.net/html/archive/foodse/060504acf.asp?sector=FOODSE p.18 [T Chenoweth])
Most of the interviewed people in both districts did not know their HIV/AIDS status for two main reasons: - The VCT (Voluntary Counselling and Testing) or PPTCT (Prevention of Parents To Child Transmission) tests are only available at hospital level (1 hospital in the whole Zvishavane district and 3 in Chipinge).n- Most people say they would rather ignore their status as HIV/AIDS might be a source of stigmatisation.
3. No solvency - Lack of infrastructure, doctors, and HIV testing means the drugs can’t be distributed anyways.
Washington Post – Your Author, 4/20/05 (In Rural Zimbabwe AIDS Still Means Death, http://www.washingtonpost.com/wp-dyn/articles/A2441-2005Apr19.html)
By this measure, Mataruse could not live in a worse place. Zhulube is a remote region in southern Zimbabwe, a country whose public health system has been decimated by economic collapse and international isolation. In southern Africa, the epicenter of the global pandemic, no country is as far behind in treating AIDS, according to World Health Organization statistics. An estimated 1.8 million Zimbabweans have HIV, the virus that causes AIDS. Of that group, 295,000 need antiretroviral treatment immediately, but only 8,000 -- less than 3 percent -- are getting it, according to a December report from WHO. The need for treatment is growing far more quickly than the capacity to provide it, the report shows. Mataruse's local clinic, an arduous three-mile walk from her home, lacks not only antiretroviral medicine but also the kits needed to test for HIV. Even the basics of modern health care -- syringes, intravenous fluid, antibiotics and elastic bandages -- are frequently out of stock, a nurse at the clinic said. There are no doctors there. The nurses who have chronicled Mataruse's decline have never mentioned either HIV or AIDS, she said, and neither term appears in the battered paper folder of medical records she keeps. The surge of international funding that is beginning to prolong the lives of Africans with AIDS has bypassed Zimbabwe almost entirely. The United Nations, the World Bank and President Bush's AIDS initiative are focusing on other countries, in large part because President Robert G. Mugabe's reputation as one of the most undemocratic and anti-Western African leaders has kept donors away from Zimbabwe. "There is tension between the international community and the government of Zimbabwe," said James Elder, a UNICEF spokesman in Harare, the capital. But he added, "Don't take it out on children. Let's move the attention a little bit away from politics and put it on people." The average amount of international funding each year in southern Africa is $74 per person infected with HIV, according to UNICEF. In Zimbabwe, that figure is $4. The discrepancy is even more dramatic when compared with sums received over the border in Zambia, where international donors provide $187 per infected person. And though Zimbabwe is slated to get a grant of $14 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the same agency rejected a request in December for more than $250 million, citing technical flaws in the proposal. The results can be seen in the relative availability of medicine. In Zambia, antiretroviral drugs are reaching 13 percent of those who need them, according to WHO statistics. Zimbabwe's southwestern neighbor, Botswana, which has a much higher per capita income and receives substantial health care funding from the Bill and Melinda Gates Foundation, is getting antiretrovirals to 50 percent of those who need it. Even in South Africa, which has been widely criticized for its sluggish response to AIDS, antiretrovirals are reaching 7 percent of those who need the drugs. In major South African cities such as Johannesburg and Cape Town, the waiting list for government-subsidized AIDS medicines has virtually disappeared, doctors there said. While the governments of most countries hit hardest by AIDS have cooperated with international donors, Mugabe's government has grown increasingly belligerent toward the West, especially the United States and Britain, which he regularly attacks with caustic rhetoric. Mugabe has won some international praise for his willingness to discuss AIDS publicly, in contrast to South African President Thabo Mbeki. He revealed in a speech last year that members of his family had contracted the disease, and the government also instituted a tax supposedly intended to generate resources to fight AIDS. But many Zimbabweans express doubt that the money raised by the levy has gone to treating or preventing AIDS. There are few public health messages about HIV anywhere in the country, aside from a handful of vaguely worded billboards promoting condom use. The reputation of Mugabe and his ruling party for siphoning public funds for private gain, meanwhile, has made the major international donors even more reluctant to deal with him. And the parliament passed a law last year to bring independent aid groups, which might provide an alternative for delivering international health assistance, under government control. The victims in this standoff between Mugabe and Western donors are Zimbabweans with AIDS, activists here said. "You can't win this battle by fighting the government, because they control the resources," said Lynde Francis, an AIDS activist in nearby Bulawayo. "It doesn't matter how much you whine and moan about the government. It doesn't get you anywhere to withdraw help." One of the few international donors to make a significant commitment to fighting AIDS in Zimbabwe is the studiously non-partisan French medical group Doctors Without Borders, which has managed to make Bulawayo the only city in Zimbabwe where antiretrovirals are widely available. A Zimbabwean company is also beginning to make a generic version of a popular combination of antiretroviral drugs, which might improve access. But here in Zhulube, a dusty, destitute village in a gold-mining region, the public health system has trouble handling even comparatively simple maladies such as pneumonia or infected wounds. Mataruse has walked to the clinic almost monthly in the past two years, complaining of coughs, headaches, fever, diarrhea and night sweats. Her health records show she was routinely given nothing more than painkillers.